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13 results

  • p16 status and interval neck dissection findings after a ‘clinically complete response’ to chemoradiotherapy in oropharyngeal squamous cell carcinoma

  • M S Miah, P Spielmann, S J White, C Kennedy, N Kernohan, R E Mountain, R Cassasola, S Mahendran
  • Journal:
    The Journal of Laryngology & Otology / Volume 129 / Issue 8 / August 2015
    Published online by Cambridge University Press:
    19 June 2015, pp. 801-806
    Print publication:
    August 2015
  • Objectives:

    To evaluate the histopathological findings from post-treatment neck dissection of p16 positive and negative oropharyngeal carcinoma cases, after completion of chemoradiotherapy, and to question the role of neck dissection after a ‘clinically complete response’ to chemoradiotherapy.

    Methods:

    Data were collected retrospectively from a cohort of patients treated with curative intent using chemoradiotherapy and post-treatment neck dissection. Primary tumours underwent p16 immunohistochemistry. Neck dissection specimens were examined for viable cancer cells.

    Results:

    A total of 76 cases were assessed. Viable cancer cells were detected from neck dissection in 29 per cent of p16 negative cases. Locoregional recurrence occurred in 12.9 per cent of p16 negative cases. The association between p16 positivity in the primary tumour and histopathologically negative neck dissection was significant (p < 0.05).

    Conclusion:

    p16 status appeared to be an independent marker of disease control for the cohort in this study. The data raise questions about the role of post-treatment neck dissection in p16 positive cases with a ‘clinically complete response’ to chemoradiotherapy.

Acute Pain Management
  • Edited by Raymond S. Sinatra, Oscar A. de Leon-Cassasola, Eugene R. Viscusi, Brian Ginsberg
  • Foreword by Henry McQuay
  • Published online:
    26 October 2009
    Print publication:
    27 April 2009
  • This textbook is written as a comprehensive overview of acute pain management. It is designed to guide clinicians through an impressive array of different options available to them and to patients. There has been a flurry of interest in the extent to which acute pain can become chronic pain, and how we might reduce the incidence of such chronicity. This overview covers a wide range of treatments for pain management, including the anatomy of pain pathways, the pathophysiology of severe pain, pain assessment, therapeutic guidelines, analgesic options, organization of pain services, and the role of anesthesiologists, surgeons, pharmacists, and nurses in providing optimal care. It also discusses the use of patient-controlled analgesia and how this may or may not be effective and useful.